Heights University Hospital

All Charges

Charge

Type

Setting

Price

HYDROCORTISONE OINT 0.2%/15GM

Facility

$659.28

Service Code	NDC 45802045535
Hospital Charge Code	60628866
Hospital Revenue Code	250
Min. Negotiated Rate	$85.71
Max. Negotiated Rate	$329.64
Rate for Payer: Aetna Commercial	$197.78
Rate for Payer: Aetna Medicare Advantage	$197.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.12
Rate for Payer: Cigna Commercial	$329.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$85.71
Rate for Payer: Oxford Commercial	$329.64
Rate for Payer: Qualcare PPO/HMO/WC	$98.89
Rate for Payer: UnitedHealthcare Commercial	$329.64

HYDROCORTISONE-PRAMOXINE FOAM

Facility

$1,006.21

Service Code	NDC 37682210
Hospital Charge Code	6007397
Hospital Revenue Code	251
Min. Negotiated Rate	$130.81
Max. Negotiated Rate	$503.11
Rate for Payer: Aetna Commercial	$301.86
Rate for Payer: Aetna Medicare Advantage	$301.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$256.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$256.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$256.58
Rate for Payer: Cigna Commercial	$503.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.81
Rate for Payer: Oxford Commercial	$503.11
Rate for Payer: Qualcare PPO/HMO/WC	$150.93
Rate for Payer: UnitedHealthcare Commercial	$503.11

HYDROCORTISONE-PRAMOXINE FOAM

Facility

$1,006.21

Service Code	NDC 37682210
Hospital Charge Code	6007397
Hospital Revenue Code	251
Min. Negotiated Rate	$150.93
Max. Negotiated Rate	$150.93
Rate for Payer: Qualcare PPO/HMO/WC	$150.93

HYDROCORTISONE SUCC 250MG VIAL

Facility

$127.57

Service Code	HCPCS J1720
Hospital Charge Code	6063943206
Hospital Revenue Code	636
Min. Negotiated Rate	$19.14
Max. Negotiated Rate	$38.27
Rate for Payer: Aetna Commercial	$38.27
Rate for Payer: Aetna Medicare Advantage	$38.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.53
Rate for Payer: Cigna Commercial	$22.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.87
Rate for Payer: Qualcare PPO/HMO/WC	$19.14

HYDROCORTISONE SUCC 250MG VIAL

Facility

$127.57

Service Code	HCPCS J1720
Hospital Charge Code	6063943206
Hospital Revenue Code	636
Min. Negotiated Rate	$19.14
Max. Negotiated Rate	$30.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.87
Rate for Payer: Qualcare PPO/HMO/WC	$19.14

HYDROCORT LOT 1%

Facility

$73.00

Hospital Charge Code	60628391
Hospital Revenue Code	250
Min. Negotiated Rate	$10.95
Max. Negotiated Rate	$10.95
Rate for Payer: Qualcare PPO/HMO/WC	$10.95

HYDROCORT LOT 1%

Facility

$73.00

Hospital Charge Code	60628391
Hospital Revenue Code	250
Min. Negotiated Rate	$9.49
Max. Negotiated Rate	$36.50
Rate for Payer: Aetna Commercial	$21.90
Rate for Payer: Aetna Medicare Advantage	$21.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.61
Rate for Payer: Cigna Commercial	$36.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.49
Rate for Payer: Oxford Commercial	$36.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.95
Rate for Payer: UnitedHealthcare Commercial	$36.50

HYDROCORT NEO PLY BAC 3.5GM ON

Facility

$109.45

Hospital Charge Code	6002893
Hospital Revenue Code	251
Min. Negotiated Rate	$16.42
Max. Negotiated Rate	$16.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.42

HYDROCORT NEO PLY BAC 3.5GM ON

Facility

$109.45

Hospital Charge Code	6002893
Hospital Revenue Code	251
Min. Negotiated Rate	$14.23
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$32.84
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.23
Rate for Payer: Oxford Commercial	$54.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$54.73

HYDROCORT NEO POLY CRM 7.5GM

Facility

$19.25

Hospital Charge Code	6002851
Hospital Revenue Code	251
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

HYDROCORT NEO POLY CRM 7.5GM

Facility

$19.25

Hospital Charge Code	6002851
Hospital Revenue Code	251
Min. Negotiated Rate	$2.50
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$5.78
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.50
Rate for Payer: Oxford Commercial	$9.62
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$9.62

HYDROCORT NEO POLY OINT 15GM

Facility

$64.00

Hospital Charge Code	6002869
Hospital Revenue Code	251
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

HYDROCORT NEO POLY OINT 15GM

Facility

$64.00

Hospital Charge Code	6002869
Hospital Revenue Code	251
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$19.20
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.32
Rate for Payer: Oxford Commercial	$32.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$32.00

HYDROCORT NEO POLY OPHT 7.5ML

Facility

$109.45

Hospital Charge Code	6002877
Hospital Revenue Code	251
Min. Negotiated Rate	$14.23
Max. Negotiated Rate	$54.73
Rate for Payer: Aetna Commercial	$32.84
Rate for Payer: Aetna Medicare Advantage	$32.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.91
Rate for Payer: Cigna Commercial	$54.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.23
Rate for Payer: Oxford Commercial	$54.73
Rate for Payer: Qualcare PPO/HMO/WC	$16.42
Rate for Payer: UnitedHealthcare Commercial	$54.73

HYDROCORT NEO POLY OPHT 7.5ML

Facility

$109.45

Hospital Charge Code	6002877
Hospital Revenue Code	251
Min. Negotiated Rate	$16.42
Max. Negotiated Rate	$16.42
Rate for Payer: Qualcare PPO/HMO/WC	$16.42

HYDROCORT NEO POLY OTIC 10ML

Facility

$86.40

Hospital Charge Code	6002885
Hospital Revenue Code	251
Min. Negotiated Rate	$12.96
Max. Negotiated Rate	$12.96
Rate for Payer: Qualcare PPO/HMO/WC	$12.96

HYDROCORT NEO POLY OTIC 10ML

Facility

$86.40

Hospital Charge Code	6002885
Hospital Revenue Code	251
Min. Negotiated Rate	$11.23
Max. Negotiated Rate	$43.20
Rate for Payer: Aetna Commercial	$25.92
Rate for Payer: Aetna Medicare Advantage	$25.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.03
Rate for Payer: Cigna Commercial	$43.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.23
Rate for Payer: Oxford Commercial	$43.20
Rate for Payer: Qualcare PPO/HMO/WC	$12.96
Rate for Payer: UnitedHealthcare Commercial	$43.20

HYDROCORT OINT 0.2%

Facility

$276.00

Hospital Charge Code	60628399
Hospital Revenue Code	250
Min. Negotiated Rate	$41.40
Max. Negotiated Rate	$41.40
Rate for Payer: Qualcare PPO/HMO/WC	$41.40

HYDROCORT OINT 0.2%

Facility

$276.00

Hospital Charge Code	60628399
Hospital Revenue Code	250
Min. Negotiated Rate	$35.88
Max. Negotiated Rate	$138.00
Rate for Payer: Aetna Commercial	$82.80
Rate for Payer: Aetna Medicare Advantage	$82.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.38
Rate for Payer: Cigna Commercial	$138.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.88
Rate for Payer: Oxford Commercial	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.40
Rate for Payer: UnitedHealthcare Commercial	$138.00

HYDROCORTONE/10G/TAB

Facility

$3.00

Hospital Charge Code	60634379
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

HYDROCORTONE/10G/TAB

Facility

$3.00

Hospital Charge Code	60634379
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HYDROCORTONE/20MG/TAB

Facility

$3.00

Hospital Charge Code	60634378
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

HYDROCORTONE/20MG/TAB

Facility

$3.00

Hospital Charge Code	60634378
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$0.90
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.39
Rate for Payer: Oxford Commercial	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$1.50

HYDROCORT POLY OTC SOL .5%10ML

Facility

$37.80

Hospital Charge Code	6002984
Hospital Revenue Code	251
Min. Negotiated Rate	$4.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$11.34
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.91
Rate for Payer: Oxford Commercial	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$18.90

HYDROCORT POLY OTC SOL .5%10ML

Facility

$37.80

Hospital Charge Code	6002984
Hospital Revenue Code	251
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

Know your out-of-pocket cost for care.

All Charges